Saturday, July 28, 2018

Sayings of Epictetus

I came across the sayings of the great Greek Stoic Epictetus while reading "Poor Charlie's Almanack". Epictetus was born a slave but rose to become a respected philosopher. The central theme of his teachings is that we should use all mishaps in life for improving ourselves and not blame others or the Gods for it. His epitaph, written by himself, itself read, "Here lies Epictetus, a slave maimed in body, the ultimate in poverty, and the favored of the gods.".



I found his teachings quite profound and found a blog post providing a summary. Here are a few of my favorite ones:

  • “I [Zeus] gave you a portion of our divinity, a spark from our own fire, the power to act and not to act, the will to get and the will to avoid. If you pay heed to this, you will not groan, you will blame no man, you will flatter none” 
  • "Wealth consists not in having great possessions, but in having few wants. Seek not the good in external things; seek it in yourselves. Freedom is not procured by a full enjoyment of what is desired, but by controlling the desire.”
  • “Don't explain your philosophy. Embody it. Don't just say you have read books. Show that through them you have learned to think better, to be a more discriminating and reflective person. Books are the training weights of the mind. They are very helpful, but it would be a bad mistake to suppose that one has made progress simply by having internalized their contents." 
  • “Man is not worried by real problems so much as by his imagined anxieties about real problems. It's not what happens to you, but how you react to it that matters.” 
  • “If you want to improve, be content to be thought foolish and stupid.” 
  • “The key is to keep company only with people who uplift you, whose presence calls forth your best.” 
  • “Any person capable of angering you becomes your master; he can anger you only when you permit yourself to be disturbed by him.” 
  • “Other people's views and troubles can be contagious. Don't sabotage yourself by unwittingly adopting negative, unproductive attitudes through your associations with others.” 
  • “He who laughs at himself never runs out of things to laugh at.” 
  • “Circumstances don't make the man, they only reveal him to himself.” 
  • “To accuse others of one's own misfortune is a sign of want of education. To accuse oneself shows that one's education has begun. To accuse neither oneself nor others shows that one's education is complete.” 
  • “It is impossible for a man to learn what he thinks he already knows.” 
  • “First learn the meaning of what you say, and then speak.” 
  • “Do not try to seem wise to others. ” “Don't seek to have events happen as you wish, but wish them to happen as they do happen, and all will be well with you.” 
  • “If you would cure anger, do not feed it. Say to yourself: 'I used to be angry every day; then every other day; now only every third or fourth day.' When you reach thirty days offer a sacrifice of thanksgiving to the gods.” 
  • “Difficulty shows what men are. Therefore when a difficulty falls upon you, remember that God, like a trainer of wrestlers, has matched you with a rough young man. Why? So that you may become an Olympic conqueror, but it is not accomplished without sweat.” 
  • “Even as the Sun doth not wait for prayers and incantations to rise, but shines forth and is welcomed by all: so thou also wait not for clapping of hands and shouts and praise to do thy duty; nay, do good of thine own accord, and thou wilt be loved like the Sun.” 
  • “These reasonings are unconnected: "I am richer than you, therefore I am better"; "I am more eloquent than you, therefore I am better." The connection is rather this: "I am richer than you, therefore my property is greater than yours;" "I am more eloquent than you, therefore my style is better than yours." But you, after all, are neither property nor style.” 
  • “Control thy passions lest they take vengeance on thee.” 
  • “A guide, on finding a man who has lost his way, brings him back to the right path—he does not mock and jeer at him and then take himself off. You also must show the unlearned man the truth, and you will see that he will follow. But so long as you do not show it to him, you should not mock, but rather feel your own incapacity.” 
  • “It is our attitude toward events, not events themselves, which we can control. Nothing is by its own nature calamitous -- even death is terrible only if we fear it.” 
  • “Men are disturbed not by things, but by the views which they take of things. Thus death is nothing terrible, else it would have appeared so to Socrates. But the terror consists in our notion of death, that it is terrible. When, therefore, we are hindered, or disturbed, or grieved let us never impute it to others, but to ourselves; that is, to our own views. It is the action of an uninstructed person to reproach others for his own misfortunes; of one entering upon instruction, to reproach himself; and of one perfectly instructed, to reproach neither others or himself.” 
  • “To Epictetus, all external events are determined by fate, and are thus beyond our control, but we can accept whatever happens calmly and dispassionately. Individuals, however, are responsible for their own actions which they can examine and control through rigorous self-discipline. Suffering arises from trying to control what is uncontrollable, or from neglecting what is within our power. As part of the universal city that is the universe, human beings have a duty of care to all fellow humans. The person who followed these precepts would achieve happiness.” 
  • “Do not afflict others with anything that you yourself would not wish to suffer. if you would not like to be a slave, make sure no one is your slave. If you have slaves, you yourself are the greatest slave, for just as freedom is incompatible with slavery, so goodness is incompatible with hypocrisy.” 
  • “Tentative efforts lead to tentative outcomes. Therefore, give yourself fully to your endeavors. Decide to construct your character through excellent actions and determine to pay the price of a worthy goal. The trials you encounter will introduce you to your strengths. Remain steadfast...and one day you will build something that endures: something worthy of your potential.” 
  • “On the occasion of every accident that befalls you, remember to turn to yourself and inquire what power you have for turning it to use.” 
  • “No great thing is created suddenly, any more than a bunch of grapes or a fig. If you tell me that you desire a fig, I answer that there must be time. Let it first blossom, then bear fruit, then ripen.” 
  • “What then, is it not possible to be free from faults? It is not possible; but this is possible: to direct your efforts incessantly to be faultless. For we must be content if by never remitting this attention we shall escape at least a few errors. When you have said ‘Tomorrow I will begin to attend,’ you must be told that you are saying this: ‘Today I will be shameless, disregardful of time and place, mean; it will be in the power of others to give me pain, today I will be passionate and envious.’” 
  • "You know yourself what you are worth in your own eyes; and at what price you will sell yourself. For men sell themselves at various prices." 
  • “Most of what passes for legitimate entertainment is inferior or foolish and only caters to or exploits people's weaknesses. Avoid being one of the mob who indulges in such pastimes. Your life is too short and you have important things to do. Be discriminating about what images and ideas you permit into your mind. If you yourself don't choose what thoughts and images you expose yourself to, someone else will, and their motives may not be the highest. It is the easiest thing in the world to slide imperceptibly into vulgarity. But there's no need for that to happen if you determine not to waste your time and attention on mindless pap.” 
  • “So you wish to conquer in the Olympic Games, my friend? And I, too... But first, mark the conditions and the consequences. You will have to put yourself under discipline; to eat by rule, to avoid cakes and sweetmeats; to take exercise at the appointed hour whether you like it or not, in cold and heat; to abstain from cold drinks and wine at your will. Then, in the conflict itself, you are likely enough to dislocate your wrist or twist your ankle, to swallow a great deal of dust, to be severely thrashed, and after all of these things, to be defeated.” 
  • “Now is the time to get serious about living your ideals. How long can you afford to put off who you really want to be? Your nobler self cannot wait any longer. Put your principles into practice – now. Stop the excuses and the procrastination. This is your life! You aren’t a child anymore. The sooner you set yourself to your spiritual program, the happier you will be. The longer you wait, the more you’ll be vulnerable to mediocrity and feel filled with shame and regret, because you know you are capable of better. From this instant on, vow to stop disappointing yourself. Separate yourself from the mob. Decide to be extraordinary and do what you need to do – now.” 
  • “Small-minded people blame others. Average people blame themselves. The wise see all blame as foolishness” 

Sunday, July 8, 2018

Summary of ICC's Cracking the Wellness Code Health Summit

Today I attended the Health Summit, Cracking the Wellness Code organized by the India community center. The summit had an impressive line of speakers - 11 MDs and a health tech entrepreneur. This was a great event and helped answer many health related questions I had. I am presenting the summary of the talks here, so that this can benefit others and so that I can also come back to it later. You could also watch the recordings here.

It was interesting to see that there was fair amount of disagreement between the doctors at the summit itself, e.g. regarding ghee. I consider that a good sign as that shows that the organizers invited doctors from a diverse background. However, there were a lot of similarities also. If you are short on time, you could jump to the summary section in the end.

I tried my best to capture the notes, but it's highly likely I might have gotten something wrong. Please take the following with a pinch of salt.


Keynote: Food that gets us hooked and how to get unhooked - Dr Neal Barnard, MD
  • Sugar triggers dopamine release.
  • Cheese is bad. It's high fat, 70% saturated fat. 
  • Milk related to infertility. Milk is rich in estrogen. Men who consumed more milk had lower sperm count. Women who consumed more cheese / butter had 49% more chances of breast cancer. 
  • Dairies are to cruel to cows. They are forcibly impregnated every year. The calf and the cows are separated at birth. If you live near a farm, you can hear their cries at night. Dr Barnard, comes from a family of cattle farmers, so he has seen this firsthand.
  • Animal protein can harm kidneys.
  • How to get Calcium without milk? Only 30% calcium in milk is absorbed by our body. Green veggies (Broccoli, Kale, Brussel sprouts etc) have a much higher absorption ratio. Spinach has lots of calcium but doesn't have a high absorption ratio.
  • Keto / Low carb diets - Every ~17 years low carb diets come back. You do lose weight but you end up with higher cholesterol in the end. Also it becomes much harder to come back to normal food afterwards. Mortality is also higher.
  • Soy milk - Internet says soys have hormones that can cause cancer / hormonal imbalance. Soy doesn't cause infertility e.g. China, Japan consume a lot of Soy but don't really have any issues. Women who consumed Soy had less breast cancer.  Women who avoided soy have high Mortality. You don't necessarily need to have it. But consuming it doesn't hurt it either.
  • Ghee - It's bad too. But there is always pain in going away from traditions.
  • Is Veganism suitable for kids / in pregnancy - Always good.
  • How to complete nutrition - veggies, legumes, fruits, whole grains
  • Supplements : B12 supplement (used to comes from bacteria). How much? Lowest dose you can find, all have more than what we need. Sunlight for D. O/w take D supplement.
  • Children with Asthama - Veganism is the way.

Talk 2: Prevent and Reverse Chronic Diseases (Diabetes, Obesity and Heart disease) by Treating the Cause - Dr Pankaj Vij, MD
  • Obesity #1 cause of: Diabetes, high blood pressure (HBP), Cardio disease, Strokes, Cancer, Sleep apnea.
  • Every other person will be obese in the US by 2030
  • The bad news: No quick fix. Need long term, sustainable changes.
  • All calories are not bad. A shot glass and banana have the same calories, but not the same effect.
  • Causes of developing insulin resistance:
    • Excessive refined carbs
    • Fat overconsumption
    • Lack of fiber and micronutrients
    • Inflammation, oxidants, toxins
    • Inactivty
    • Stress, lack of sleep.
  • We're hard wired to have an appetite, eat when food is available and hold onto fat.
  • Today: Abundance of food, less movement and sleep, constant stress.
  • Good news:Treating the root cause can prevent and reverse chronic diseases like : Type 2 Diabetes, Obesity and Heart disease.
  • Every bite counts: 80% of health is food, food is medicine not entertainment, it is energy + intelligence.
  • How to bring change:
    1. Meal timing and frequency: We had a long history of eating 1-2 meals a day, periods of Meal timing and frequency: Long history of 1-2 meals a day, periods of intermittent fasting. We have higher Insulin sensitivity earlier in the day - so should eat more earlier in the day. Know your hunger - is it craving?
    2. Resistance exercises / strength training: Positively affects weight loss. In Indian tradition, you had to squat even to go to the bathroom.
    3. Sleep
    4. Meditation, Pranayama, Nature - to activate parasympathetic nervous system.
    5. Set the environment for success - change mindset of growth that you are bettering yourself and not feel miserable. Keep good food in house / office. Surround yourself with health heros.
  • T1 diabetes: genetic (10% of all diabetes). Can still be improved. Rest 90% can be completely prevented.
  • Soy: No risk of it raising estrogen.
  • Intermittent fasting (IF) seems to one of most powerful element. East breakfast like a king, ..... Dinner early and smaller - this helps in sleeping better.
  • Things to avoid - sat / trans fat, no meat, diary / cheese / chicken, processed carbs, alcohol, packaged food, namkeen, Sugar.
  • Food for good sleep: light meal at night.
  • Are supplements good: avoid as much as possible. If you are 100% vegan - omega 3: algae sources, if over 50 - cortisol
  • Summary: How to make disease optional -- think like a bear!
    • Nutrient dense plant rich colorful diet
    • Whole unprocessed diet
    • Fasting
    • Move a lot
    • Sleep
    • Left heavy things
    • Get outside
    • Give bear hugs!

Talk 3: Finding Hidden Joy and Meaning - Dr Mark Moeller, MD
  • Tools to be happy:
    • Priming - think of a happy memory.
    • Framing - state what you think is true in a more helpful and positive way.
    • Habits - learning to prime, frame - repeatedly.

Talk 4: Panchakarma - Ancient Biohack to Reset the Gut for Optimal Energy, Immunity & Longevity - Dr Vignesh Devraj, MD, Ayurveda
  • Quality of health is the quality of waste elimination. In Ayurveda, how are you is - how are your motions?
  • Diseases of overnutrition are harder / more common than undernutrition.
  • Ama (posion in ayurveda) - means not me. Niramaya is the state of optimal health.
  • In Ayurveda, sweet is sticky. The sweeter it is, harder it is for the body to break is down, consume, eliminate. Sweet IS poison.
  • Priority of cleaning: Gut, blood, then body.
  • Panchakarma - gut cleaning: helps improves health.
  • Alcohol is used as a medicine. Many herbs are mixed with it. That's it. It's a medicine, should be taken like that.
  • Ghee: Has high level of omega 3. Anti adhesive. Improves intellect and brain. Ayurveda considers ghee good in moderation. Don't cook in oil.

Talk 5: The Paleovedic Diet: Integrating Early Human Diets and Ayurvedic Medicine - Dr Akhil Palaniswamy, MD
  • Approach: 1. Food 2. Spices 3. _ 4. _
  • Good diet:
    • Fiber
    • Variety: Target 20 different type of plant food per week.
    • Micronutrients
  • Choose the most nutrient foods and veggies.
  • Avoid refined grains, vegetable oils, trans fats.
  • "When diet is wrong, medicine is no use. When diet is right, medicine is of no need." -Ayurveda
  • 3 dosah: Vata, Pitta, Kafa. Imbalance causes disease. Find your body type and eat according to it.
  • Good fats: Avocado, Olive oil, ghee, sesame oils
  • Spices: Most nutrient dense food, high antioxidants, reduce inflammation, support digestion
  • Some veggies are better raw, some cooked. Cooked tomatoes are better.
  • Cooked or raw veggies - Broccoli / carrots better raw or lightly cooked.
  • Fats and obesity: Eating fat doesn't make you fat in general. For most people good fats are not bad. Moderation is the key.
  • Opinion on ghee, coconut and sesame oils: All good.
  • Turmeric and black pepper are good. Combine together with good fat and consume.
  • Recommended spices: Ginger, cinnamon, methi, cumin, -- mainly 13 spices.
  • Keto is extreme. Helps in certain medical condition. Not recommended long term.
  • Veg fruit juicing: supplements the nutrition. Shouldn't be majority source. Whole nutrition is better. Use occasionally.

Talk 6: Escaping The Pleasure Trap - Dr Alan Goldhamer, MD
  • The question is not how you are going to die, but how you will live?
  • Actual causes of death: Tobacco, BP, alcohol, cholesterol, oversight, unsafe sex
  • Chemicals that artificially increase Dopamine: Sugar. Increased 1000% since 1986.
  • Ice cream - frozen tastes good, melted makes you sick. You can't sense sweetness in cold.
  • Bad food: ice cream, bread, sugar, coke
  • 25% of calories of teenagers comes from soda drinks.
  • Dairy products commonly cause auto immune disease - thyroid, arthritis, etc

Lunch break: Talking to the two Ayurvedic doctors
  • Milk / yogurt: Avoid if there is any problem - like inflammation, obesity, auto immune Diseases. Otherwise ok. Not losing out if you don't drink.
  • Ghee: it is good. Don't cook it though. 1 or 2 teaspoons a day is recommended.
  • In arthritis: Avoid milk, gluten, sugar. Ghee is ok. See Ayurveda doctor. Panchakarma is useful too.

Talk 7: Parenting Style and Obesity in Children -- Dr Seema Kumar, MD
  • 1 in 4 child in US is overweight. Old age diseases (diabetes, BP, cholesterol) are becoming common in them.
  • Asian Indians: Visceral fat - causes heart diseases.
  • Unique factors in Indian household: traditional belief about health and nutrition. Overprotection and forced feeding by parents. We feed children when they are not hungry. Moms feeding 6-7 years old.
  • Veg diet can be unhealthy. Fried. Indian hospitality means overfeeding. Over eating sweets.
  • Increase pressure for academics. Reduced emphasis on free play and recreational sports.
  • Excess weight problem come from lack of self control. Low demand and high reciprocal style parenting helps in developing self control in kids.
  • Make kids eat in moderation. Green food can eat in any amount - e.g. salad. Red as less as possible. Yellow ok.
  • Get kids involved in grocery shopping and cooking. Start as early as possible. Keep away from sugar.
  • Parents need to learn the correct portion size.
  • Be a +ve role model. Be proactive before child becomes obese. Family needs to be together in diet and exercise.
  • 5210 method: 5 servings of veg and fruits,  < 2 hours of screen time, > 1 hr activity per day, 0 sugary beverage.
  • The heavier you are, lower your Vitamin D are. Obesity leads to low D, which leads to high BP and sugar. Vitamin D doesn't affect cholesterol level. There is no good research available.
  • Vitamin D vs D3: Vitamin D helps in calcium and phosphorous absorption. Plant derived D2, animal D3. On daily basis,it doesn't matter which. On monthly, take D3.

Talk 8: Diabetes Technology Update - Dr Archana Bindra MD
  • Indians 3X most likely than the rest of the world. South India more than North India.
  • At the time of diabetes diagnosis, you have already lost 50% of beta cells which manufacture insulin.
  • Insulin is needed for glucose to enter cell wall. With insulin resistance, you need extra insulin to make the glucose enter the cells.
  • Losing weight can help improve insulin activity.

Talk 9: Fasting Can Save Your Life - Dr  Alan Goldhamer DC
  • healthpromoting.com
  • Average american will spend their last 10 years in sickness.
  • Types of fasting: IF: 8 hours of eating, 16 hours rest. Water only fasting.
  • With fasting you need rest. O/w you need glucose for physical and mental activity. For that you will end up burning protein in muscles.
  • Cured cancer - 21 day water fasting and plant based diet afterwards
  • High BP : Medicines have side effects. How to fix: lose weight, diet, aggressive salt reduction.
  • Is fasting safe: can be done safely in young and old people
  • All things that go up with exercise, go up with fasting also. Both undo dietary excess
  • Fast mechanism:
    1. Weight loss
    2. Lose excess sodium
    3. Detoxification: removes both external and internal toxins
    4. Combination of fasting and chemotherapy is more effective them chemo only
    5. Restores enzyme functions
    6. Cures insulin Resistance
    7. Normalizes sympathetic tone
    8. Spirituality
    9. Enhances immune systems
    10. Taste neuroadaption

Talk 10: Seven health hacks I bet you did not know! -  Munjal Shah, Founder Health IQ

1. Old breakfast, New: IF helps. Fasting 72 hrs, 100% WBC gets replaced, new immune system.
2. Old cardio, new: heavy lifting and sprints. Lift 85% of 1 rep max.
3. Old: Burn calories during workout. New: Maximixe after workout. During the last 5 min of exercise, do it as vigorously as possible.
4. Old way: Juicing is super healthy. New: No juicing. Cocunut is exception. Drink black tea.
50% Indians, are lactose intolerance.
5. Old: Diest soda, new: No soda. Artificial sweetners induce gluose intolerance.
6. Old; Switch to whole bread, brown rice. New: Don't eat bread or rice.
7: Old: Everything moderation, new: eliminate. Elimniation is easier to implement.
8: Old: Eat when you are hungry. New: Use glucose monitor.

Figs are not pure vegetarian.


Talk 11 : Diabetes, its complications, and why should you care - Dr Lida Faroqi, MD, Stanford
  • Indians can be skinny and diabetic. Indian, above 30 --> get tested.
  • Wear shoes that are comfortable. Reduces pressure. Prevents amputations.
  • Feel your pulse on feet. First sign begins there.
  • Why legs are affected: Furthest point from heart.
  • Biggest complications: Kidneys, Eyes, Feet - get tested yearly.
  • If you have diabetes / BP medicines once, do you have to take whole like? No, if you can maintain it for 6 months, gradually reduce and remove it.
  • What kind of exercise is best: 30 mins a day / 5 days a week can reverse diabetes. Weights - building muscle.
  • Stress increases sugar level.

Talk 12: Reversing heart disease and diabetes: When a doctor becomes a patient - Dr Rajiv Misquitta MD
  • I couldn't attend most of it. 
  • Follow Dean Ornish's diet
  • Avoid avocado / nuts / Oils / ghee when you are at extreme danger of heart disease.
  • Hummus is great - good for diabetics - have as much as you want
  • Movies: Forks over Knife, What the health
  • Someone solved 90% blockage -- aashram in Bangalore 45 days (yoga, diet) called vyasa.org
  • His diet sample: 
    • Breakfast: Oatmeal + berries / Tofu scramble
    • Lunch: Bulgar + curry
    • Dinner: whole wheat pasta
    • Greens twice a day

Talk 13 : Understanding Food Allergies - Dr Sanjiv Jain, MD
  • Prevalence of food allergy is going up
  • Most common vegetarian food allergens: Peanuts, milk, wheat, soy
  • Allergies are increasing because of the increase in hygiene. During childhood, we don't get affected by the bacteria that we used to. Healthy microbiom in gut is critical and plays important role. Highly processed food and antibiotics are responsible for their decay.

Summary:
Though there were quite a few disagreements between the doctors of Ayurvedic and Allopathic schools, here are the topics that were corroborate by both / multiple doctors throughout the day:

  • Importance of fasting: Detoxifies the body. Intermittent fasting is good, once a while water fast is good too.
  • Strength training: It's important to lift weights (can be body weight based exercises too).
  • Milk: Worth experimenting giving up if you are having some problems - auto immune disease, allergies, obesity, bloating.
  • Sleep / Be happy / Go out in sunlight / meditate (My addition: may be try Vipasssana?).
  • Good fat is good (except when you are in high cardiac risk area).
  • Sugar, packaged food, refined carbs are gonna kill you.
  • Alcohol is bad. If you want the medicinal properties, may be have a teaspoon a day.
  • Supplements: As less as possible. You likely just need to watch out for your D, B12 and omega 3 numbers.
  • Eat less (quantity and frequency). We are likely overeating.
  • Take care of gut and the bacteria there.


Misc: